Our four year old has type 1 diabetes and we are expecting our second baby soon. There has been a lot of publicity about using cord blood in conjunction with islet transplants to cure type 1 diabetes. Should I save the cord blood to help cure my child’s diabetes? If so, is the cord blood useless if the second child has diabetes too? It is very expensive to collect and store the blood — we really don’t have the money but we will get the money some how if we need to.

Stem cell research has been very much in the public eye recently for both scientific and political reasons, and there have been some exciting clinical applications to justify this. Treatment of Parkinsonism, certain congenital anemias and disorders of the immune system, and as well as using stem cells means of preventing organ rejection after transplants are some of them. Even more importantly, perhaps, are the hopes for other applications, particularly for type 1A (autoimmune) diabetes. In the latter case, development is still at the laboratory stage where several types of stem cells have reversed diabetes in the NOD mouse model of type 1 diabetes (see a recent article in PubMed). It will be some years though before this becomes available for humans.

In your particular case, the chance of the new baby having diabetes is only about 5% so that it is not unreasonable to think of keeping stem cells from the cord blood. Personally though, I would be against this because, at the same time, some very ingenious work in genetic engineering is being reported. Briefly what this involves is using a virus vector to introduce the insulin gene linked to a controller gene that is sensitive to blood sugar levels into liver cells for example, which are not affected by the autoimmune process. Again this is still at the animal stage.

All a little far fetched still, I am afraid, but in the meantime new insulins and new insulin regimens with soon to come non-invasive blood sugar measurement are greatly improving the prospects for children with diabetes, and, before long, islet cell transplants may be further improved so that minimal immunosuppression is needed.

DOB

[Editor’s comment: See: a recent answer to a similar question on this very topic.

SS]